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Book ; Online ; E-Book: Machine learning and deep learning techniques for medical science

Balasubramanian, Kishore / Gayathri Devi, K. G. / Ngoc, Le Anh

(Artificial Intelligence (AI): Elementary to Advanced Practices)

2022

Abstract: This book presents the integration of machine learning and deep learning algorithms that can be applied in the healthcare sector to reduce the time needed by doctors, radiologists, and other medical professionals to analyze, predict, and diagnose ... ...

Author's details	edited by K. Gayathri Devi, Kishore Balasubramanian, and Le Anh Ngoc
Series title	Artificial Intelligence (AI): Elementary to Advanced Practices
Abstract	"This book presents the integration of machine learning and deep learning algorithms that can be applied in the healthcare sector to reduce the time needed by doctors, radiologists, and other medical professionals to analyze, predict, and diagnose conditions with accurate results"--
Keywords	Deep learning (Machine learning) ; Artificial intelligence/Medical applications ; Medical informatics
Subject code	610.285
Language	English
Size	1 online resource (413 pages)
Publisher	CRC Press
Publishing place	Boca Raton, Florida
Document type	Book ; Online ; E-Book
Remark	Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
ISBN	1-00-321749-4 ; 1-003-21749-4 ; 1-000-58252-3 ; 1-03-210420-1 ; 978-1-00-321749-7 ; 978-1-003-21749-7 ; 978-1-000-58252-9 ; 978-1-03-210420-1
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article: A Randomized Controlled Trial Comparing the Effect of Phenylephrine by Intramuscular Route With Intravenous Infusion in Maintaining Haemodynamic Stability During Elective Lower Segment Caesarean Section Under Spinal Anaesthesia.

Lakshmikanthan, Chandrekanth / Gayathri, Balasubramaniam / Ramani, Swetha / Balasubramanian, Natarajan

Cureus

2023 Volume 15, Issue 1, Page(s) e34118

Abstract: Background Hypotension is a commonly encountered side effect in patients undergoing spinal anaesthesia, particularly in patients undergoing caesarean section. Phenylephrine is a widely used drug to treat spinal-induced hypotension and to maintain ... ...

Abstract	Background Hypotension is a commonly encountered side effect in patients undergoing spinal anaesthesia, particularly in patients undergoing caesarean section. Phenylephrine is a widely used drug to treat spinal-induced hypotension and to maintain hemodynamic stability. Our aim is to evaluate the effectiveness of phenylephrine given through two different routes prophylactically in prevention of post-spinal hypotension in patients undergoing caesarean section. Methods A total of 150 healthy pregnant women undergoing elective caesarean section were randomly allocated into three groups: Group M (prophylactic intramuscular use of 2 mg phenylephrine), group V (prophylactic intravenous infusion of 30 mcg phenylephrine per minute), and group P (no prophylaxis), rescue phenylephrine 30 mcg IV and atropine 0.6 mg IV were used intraoperatively to treat bradycardia and hypotension in all three groups. The primary outcome was maternal hemodynamic changes. Results There was an insignificant difference in demographic data between the groups. Maternal systolic and diastolic blood pressure were more stable in group M compared to group V and group P. Heart rate was significantly lower only in group V. We did not observe any statistical difference between the groups in the APGAR score or the fetal arterial blood gas values. The incidence of nausea and vomiting was more in group P. Conclusion Preventive intramuscular phenylephrine exhibited a more stable maternal hemodynamics when compared with the prophylactic intravenous infusion of phenylephrine and placebo in elective caesarean under spinal anaesthesia.
Language	English
Publishing date	2023-01-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.34118
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Article: Correction to: Optimized adaptive neuro-fuzzy inference system based on hybrid grey wolf-bat algorithm for schizophrenia recognition from EEG signals.

Balasubramanian, Kishore / Ramya, K / Gayathri Devi, K

Cognitive neurodynamics

2022 Volume 17, Issue 2, Page(s) 561

Abstract: This corrects the article DOI: 10.1007/s11571-022-09817-y.]. ...

Abstract	[This corrects the article DOI: 10.1007/s11571-022-09817-y.].
Language	English
Publishing date	2022-06-18
Publishing country	Netherlands
Document type	Published Erratum
ZDB-ID	2276890-7
ISSN	1871-4099 ; 1871-4080
ISSN (online)	1871-4099
ISSN	1871-4080
DOI	10.1007/s11571-022-09833-y
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Article: Patient Comfort During Postop Period in Breast Cancer Surgeries: A Randomized Controlled Trial Comparing Opioid and Opioid-Free Anesthesia.

Krishnasamy Yuvaraj, Aravindhan / Gayathri, Balasubramaniam / Balasubramanian, Natarajan / Mirunalini, Gunaseelan

Cureus

2023 Volume 15, Issue 1, Page(s) e33871

Abstract: Background: Anesthetic management practices have advanced to opioid-free anesthesia (OFA) often replacing opioids in oncologic surgeries. The study was conducted to find the quality of recovery (QoR) of patients undergoing breast cancer surgeries ... ...

Abstract	Background: Anesthetic management practices have advanced to opioid-free anesthesia (OFA) often replacing opioids in oncologic surgeries. The study was conducted to find the quality of recovery (QoR) of patients undergoing breast cancer surgeries receiving OFA. Methods: A double-blinded, randomized controlled study was conducted with 60 patients randomized to group OFA and group OA (opioid anesthesia). Group OFA received one-time dosing of ketamine 0.3 mg/kg, lignocaine 1.5 mg/kg, and dexmedetomidine 1 mcg/kg. Group OA received fentanyl 2mcg/kg. Intraoperatively, Group OFA received dexmedetomidine 0.4 mcg/kg/h and the OA group received fentanyl 0.5 mcg/kg/h infusion. Bispectral index (BIS), hemodynamics, muscle relaxant administration, and sevoflurane concentration were noted. A modified QoR-40 score was used to assess the quality of recovery in the postoperative period. Results: A higher QoR-40 score was found in the OA group (median 182, IQR 178-186) compared to the OFA group (median 180, IQR 178-184). Out of the five components, the patient's emotional state was better in the group OA (39.9±2.77) than in the OFA group (37.9±2.77). The patient's physical comfort was found to be better in the group OFA (52.52±3.23) compared to group OA (50.93±3.23). Physical independence, psychological support, and pain were comparable between the two groups. Patients in group OFA received less sevoflurane, a muscle relaxant, and showed a mild reduction in heart rate and mean arterial pressure (MAP) when compared to group OA. The time taken to reach a Modified Aldrete score of 9 was high in OFA (11.47±2.16) and (9.17±1.09) when compared to group OA. No significant differences were noted with the visual analog score (VAS) score, Ramsay sedation score, and modified post-anesthesia discharge scoring system (PADSS) score. Conclusion: We conclude that the quality of recovery of patients receiving opioid-free methods of anesthesia was not inferior to OA in patients undergoing breast cancer surgeries.
Language	English
Publishing date	2023-01-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.33871
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Article: Optimized adaptive neuro-fuzzy inference system based on hybrid grey wolf-bat algorithm for schizophrenia recognition from EEG signals.

Balasubramanian, Kishore / Ramya, K / Gayathri Devi, K

Cognitive neurodynamics

2022 Volume 17, Issue 1, Page(s) 133–151

Abstract: Schizophrenia is a chronic mental disorder that impairs a person's thinking capacity, feelings and emotions, behavioural traits, etc., Emotional distortions, delusions, hallucinations, and incoherent speech are all some of the symptoms of schizophrenia, ... ...

Abstract	Schizophrenia is a chronic mental disorder that impairs a person's thinking capacity, feelings and emotions, behavioural traits, etc., Emotional distortions, delusions, hallucinations, and incoherent speech are all some of the symptoms of schizophrenia, and cause disruption of routine activities. Computer-assisted diagnosis of schizophrenia is significantly needed to give its patients a higher quality of life. Hence, an improved adaptive neuro-fuzzy inference system based on the Hybrid Grey Wolf-Bat Algorithm for accurate prediction of schizophrenia from multi-channel EEG signals is presented in this study. The EEG signals are pre-processed using a Butterworth band pass filter and wICA initially, from which statistical, time-domain, frequency-domain, and spectral features are extracted. Discriminating features are selected using the ReliefF algorithm and are then forwarded to ANFIS for classification into either schizophrenic or normal. ANFIS is optimized by the Hybrid Grey Wolf-Bat Algorithm (HWBO) for better efficiency. The method is experimented on two separate EEG datasets-1 and 2, demonstrating an accuracy of 99.54% and 99.35%, respectively, with appreciable F1-score and MCC. Further experiments reveal the efficiency of the Hybrid Wolf-Bat algorithm in optimizing the ANFIS parameters when compared with traditional ANFIS model and other proven algorithms like genetic algorithm-ANFIS, particle optimization-ANFIS, crow search optimization algorithm-ANFIS and ant colony optimization algorithm-ANFIS, showing high R
Language	English
Publishing date	2022-05-28
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2276890-7
ISSN	1871-4099 ; 1871-4080
ISSN (online)	1871-4099
ISSN	1871-4080
DOI	10.1007/s11571-022-09817-y
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Article ; Online: Predicting diabetic foot ulceration using routinely collected data in a foot clinic. What level of prognostic accuracy can be achieved?

Naemi, Roozbeh / Balasubramanian, Gayathri / Darvel, Tracey / Chockalingam, Nachiappan

Diabetes/metabolism research and reviews

2023 Volume 39, Issue 6, Page(s) e3674

Abstract: This study aimed to investigate the efficacy of using routinely collected clinical data in predicting the risk of diabetic foot ulcer (DFU). The first objective was to develop a prognostic model based on the most important risk factors objectively ... ...

Abstract	This study aimed to investigate the efficacy of using routinely collected clinical data in predicting the risk of diabetic foot ulcer (DFU). The first objective was to develop a prognostic model based on the most important risk factors objectively selected from a set of 39 clinical measures. The second objective was to compare the prediction accuracy of the developed model against that of a model based on only the 3 risk factors that were suggested in the systematic review and meta-analyses study (PODUS). In a cohort study, a set of 12 continuous and 27 categorical data from patients (n = 203 M/F:99/104) who attended a specialised diabetic foot clinic were collected at baseline. These patients were then followed-up for 24 months during which 24 (M/F:17/7) patients had DFU. Multivariate logistic regression was used to develop a prognostic model using the identified risk factors that achieved p < 0.2 based on univariate logistic regression. The final prognostic model included 4 risk factors (Adjusted-OR [95% CI]; p) in total. Impaired sensation (116.082 [12.06-1117.287]; p = 0.000) and presence of callus (6.257 [1.312-29.836]; p = 0.021) were significant (p < 0.05), while having dry skin (5.497 [0.866-34.89]; p = 0.071) and Onychomycosis (6.386 [0.856-47.670]; p = 0.071) that stayed in the model were not significant. The accuracy of the model with these 4 risk factors was 92.3%, where sensitivity and specificity were 78.9%, and 94.0% respectively. The 78.9% sensitivity of our prognostic 4-risk factor model was superior to the 50% sensitivity that was achieved when the three risk factors proposed by PODUS were used. Also our proposed model based on the above 4 risk factors showed to predict the DFU with higher overall prognostic accuracy. These findings have implications for developing prognostic models and clinical prediction rules in specific patient populations to more accurately predict DFU.
MeSH term(s)	Humans ; Cohort Studies ; Diabetes Mellitus ; Diabetic Foot/diagnosis ; Diabetic Foot/epidemiology ; Diabetic Foot/etiology ; Foot ; Foot Ulcer ; Prognosis ; Risk Factors ; Routinely Collected Health Data
Language	English
Publishing date	2023-06-22
Publishing country	England
Document type	Journal Article
ZDB-ID	1470192-3
ISSN	1520-7560 ; 1520-7552
ISSN (online)	1520-7560
ISSN	1520-7552
DOI	10.1002/dmrr.3674
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Article: The Role of Cutaneous Microcirculatory Responses in Tissue Injury, Inflammation and Repair at the Foot in Diabetes.

Balasubramanian, Gayathri Victoria / Chockalingam, Nachiappan / Naemi, Roozbeh

Frontiers in bioengineering and biotechnology

2021 Volume 9, Page(s) 732753

Abstract: Diabetic foot syndrome is one of the most costly complications of diabetes. Damage to the soft tissue structure is one of the primary causes of diabetic foot ulcers and most of the current literature focuses on factors such as neuropathy and excessive ... ...

Abstract	Diabetic foot syndrome is one of the most costly complications of diabetes. Damage to the soft tissue structure is one of the primary causes of diabetic foot ulcers and most of the current literature focuses on factors such as neuropathy and excessive load. Although the role of blood supply has been reported in the context of macro-circulation, soft tissue damage and its healing in the context of skin microcirculation have not been adequately investigated. Previous research suggested that certain microcirculatory responses protect the skin and their impairment may contribute to increased risk for occlusive and ischemic injuries to the foot. The purpose of this narrative review was to explore and establish the possible link between impairment in skin perfusion and the chain of events that leads to ulceration, considering the interaction with other more established ulceration factors. This review highlights some of the key skin microcirculatory functions in response to various stimuli. The microcirculatory responses observed in the form of altered skin blood flow are divided into three categories based on the type of stimuli including occlusion, pressure and temperature. Studies on the three categories were reviewed including: the microcirculatory response to occlusive ischemia or Post-Occlusive Reactive Hyperaemia (PORH); the microcirculatory response to locally applied pressure such as Pressure-Induced Vasodilation (PIV); and the interplay between microcirculation and skin temperature and the microcirculatory responses to thermal stimuli such as reduced/increased blood flow due to cooling/heating. This review highlights how microcirculatory responses protect the skin and the plantar soft tissues and their plausible dysfunction in people with diabetes. Whilst discussing the link between impairment in skin perfusion as a result of altered microcirculatory response, the review describes the chain of events that leads to ulceration. A thorough understanding of the microcirculatory function and its impaired reactive mechanisms is provided, which allows an understanding of the interaction between functional disturbances of microcirculation and other more established factors for foot ulceration.
Language	English
Publishing date	2021-09-14
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2719493-0
ISSN	2296-4185
ISSN	2296-4185
DOI	10.3389/fbioe.2021.732753
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Article ; Online: Digital personal assistants are smart ways for assistive technology to aid the health and wellbeing of patients and carers.

Balasubramanian, Gayathri Victoria / Beaney, Paul / Chambers, Ruth

BMC geriatrics

2021 Volume 21, Issue 1, Page(s) 643

Abstract: Background: Digital health solutions such as assistive technologies create significant opportunities to optimise the effectiveness of both health and social care delivery. Assistive technologies include 'low-tech' items, such as memory aids and digital ... ...

Abstract	Background: Digital health solutions such as assistive technologies create significant opportunities to optimise the effectiveness of both health and social care delivery. Assistive technologies include 'low-tech' items, such as memory aids and digital calendars or 'high-tech' items, like health tracking devices and wearables. Depending on the type of assistive devices, they can be used to improve quality of life, effect lifestyle improvements and increase levels of independence. Acceptance of technology among patients and carers depends on various factors such as perceived skills and competencies in using the device, expectations, trust and reliability. This service evaluation explored the impact of a pilot service redesign focused on improving health and wellbeing by the use of a voice-activated device 'smart speaker', Alexa Echo Show 8. Methods: A service evaluation/market research was conducted for a pilot service redesign programme. Data were collected via a survey in person or telephone and from two focus groups of patients (n = 44) and informal carers (n = 7). The age of the study participants ranged from 50 to 90 years. Also, the participants belonged to two types of cohort: one specifically focused on diabetes and the other on a range of long-term health conditions such as multiple sclerosis, dementia, depression and others. Results: The device had a positive impact on the health and social well-being of the users; many direct and indirect benefits were identified. Both patients and carers had positive attitudes towards using the device. Self-reported benefits included: reminders for medications and appointments improved adherence and disease control; increased independence and productivity; and for those living alone, the device helped combat their loneliness and low mood. Conclusion: The findings from the study help to realise the potential of assistive technology for empowering supporting health/social care. Especially, the season of COVID-19 pandemic has highlighted the need for remote management of health, the use of assistive technology could have a pivotal role to play with the sustainability of health/social care provision by promoting shared care between the care provider and service user. Further evaluation can explore the key drivers and barriers for implementing assistive technologies, especially in people who are ageing and with long-term health conditions.
MeSH term(s)	Aged ; Aged, 80 and over ; COVID-19 ; Caregivers ; Humans ; Pandemics ; Quality of Life ; Reproducibility of Results ; SARS-CoV-2 ; Self-Help Devices
Language	English
Publishing date	2021-11-15
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2059865-8
ISSN	1471-2318 ; 1471-2318
ISSN (online)	1471-2318
ISSN	1471-2318
DOI	10.1186/s12877-021-02436-y
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Article ; Online: A systematic evaluation of cutaneous microcirculation in the foot using post-occlusive reactive hyperemia.

Balasubramanian, Gayathri / Chockalingam, Nachiappan / Naemi, Roozbeh

Microcirculation (New York, N.Y. : 1994)

2021 Volume 28, Issue 5, Page(s) e12692

Abstract: Objectives: Cutaneous microcirculatory impairments are associated with skin injury to the foot. Post-Occlusive reactive hyperemia (PORH) is one of the quick and easy methods to assess microcirculatory function. However, there are variations in the ... ...

Abstract	Objectives: Cutaneous microcirculatory impairments are associated with skin injury to the foot. Post-Occlusive reactive hyperemia (PORH) is one of the quick and easy methods to assess microcirculatory function. However, there are variations in the protocols currently used. Hence, this study aimed to systematically investigate the reproducibility of PORH protocols with minimal occlusion time in the foot. Methods: Post-Occlusive reactive hyperemia was measured using 12 different protocols (three occlusion times, two occlusion sites and with or without temperature control) in 25 healthy adults. Each of the 12 different protocols was repeated three times, and the intraclass correlation coefficient (ICC) was calculated. Results: Intraclass correlation coefficient showed that that ankle level occlusion produced moderate to excellent reproducibility for most PORH measures. In the right foot, 30- and 60-s ankle level occlusion without temperature control showed ICC of >0.40 for all parameters except the area of hyperemia (ICC = -0.36) and biological zero to peak flow percent change (ICC = -0.46). In the left foot, 30-s ankle level occlusion without temperature control showed ICC of >0.40 for all parameters except time to latency (ICC = 0.29), after hyperemia (ICC = 0.37), and max (ICC = -0.01), and area of hyperemia (ICC = -0.36). But the 60-s protocol showed ICC > 0.40 for all except time to max (ICC = 0.38). In the hallux protocols, all three 10-, 30-, and 60-s protocols without temperature control showed moderate to excellent reproducibility (ICC > 0.40). In most cases, the temporal and area under the perfusion-time curve parameters showed poor reproducibility. Conclusion: Post-Occlusive reactive hyperemia can be tested efficiently with a minimal occlusion time of 10 s with hallux occlusion and 30 s with ankle occlusion in the foot. This can suggest that microcirculatory assessment is feasible in routine practice and can potentially be included for routine assessment of foot in people with diabetes.
MeSH term(s)	Adult ; Humans ; Hyperemia ; Laser-Doppler Flowmetry ; Microcirculation ; Reproducibility of Results ; Skin ; Vascular Diseases
Language	English
Publishing date	2021-05-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1217758-1
ISSN	1549-8719 ; 1073-9688
ISSN (online)	1549-8719
ISSN	1073-9688
DOI	10.1111/micc.12692
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Article ; Online: GP at foot: remote ways to share management of diabetes amid the COVID-19 crisis.

Chambers, Ruth / Beaney, Paul / Balasubramanian, Gayathri / Ogunmekan, Seyi

The British journal of general practice : the journal of the Royal College of General Practitioners

2020 Volume 70, Issue 695, Page(s) 294

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/prevention & control ; Diabetes Mellitus, Type 2/therapy ; General Practitioners/organization & administration ; Humans ; Pandemics/prevention & control ; Pneumonia, Viral/prevention & control ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-05-28
Publishing country	England
Document type	Journal Article
ZDB-ID	1043148-2
ISSN	1478-5242 ; 0035-8797 ; 0960-1643
ISSN (online)	1478-5242
ISSN	0035-8797 ; 0960-1643
DOI	10.3399/bjgp20X710201
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